Writing Medical Certificates
A Review of the Standards for Doctors
HRINZ SUBMISSION - 5 July 2013
HRINZ (Human Resources Institute of New Zealand Incorporated) is a not-for-profit membership organisation representing the interests of 4000 individual members. HRINZ members include those working in private and public sector organisations, as well as students and academics. HRINZ provides members with education and information services, conferences and seminars, publications, representation at government and official levels, and networking opportunities. This helps members to develop their professional skills and knowledge in the practice and teaching of human resource management.
HRINZ supports actions that will genuinely improve the issuing of medical certificates by medical practitioners. This will better inform employers within New Zealand workplaces to manage the absences and return to work of employees due to illnesses or workplace related injuries.
HRINZ welcomes the opportunity to participate in and influence matters of this review by the Medical Council of New Zealand.
1. Do you agree with the changes proposed? If not, why not
HRINZ agrees with the proposed changes in the consultation document but would like to make the following observations and requests:
We have a concern that it does not appear to address the specific requirements and obligations of employers as they relate to compliance with the Health and Safety in Employment Act 1992 and the proposed amendments and recommendations of the Independent Taskforce on Workplace Health and Safety. In particular, where investigations are required to be carried out where a workplace injury has occurred or long term absence is due to illnesses. The employer needs to be satisfied that the employee will not cause any further harm or injury to themselves or others in their place of work when they return to work after suffering a workplace injury or illness.
Due to the difficulty that employers have in obtaining meaningful medical certificates about the impact on the employee’s ability to work, employers often end up having little access to the right information to manage the absence of an employee or their early return to work in some other capacity. Insufficient information impacts the employer’s ability to manage their business operations and may lead to health issues for other employees covering for the absent employee or further exacerbation of the employee’s health if they return to work too soon or to the wrong sort of alternative work because of the lack of accurate medical information. Employers are required to take all reasonable and practicable steps to provide a safe and healthy working environment for its employees.
HRINZ members would welcome medical certificates that contain sufficient information for the employer to make an informed decision about how to manage the employee when they return to work e.g. what the employee is capable of doing in the workplace without having to go back to the medical practitioner for further information.
HRINZ members encourage the early return to work of employees provided that they are fit for the purpose to work (i.e. the work is not going to exacerbate the employee’s medical situation). The employer can support and accommodate the employee under these circumstances where possible, to provide cost effective solutions to assist the employee in their return to work. HRINZ members would like the medical practitioners to focus on what the employee can do rather than on what they cannot do.
HRINZ recommends that there be two types of medical certificates issued – one for employers advising what the employee is capable of doing. The second is for other agencies (ACC, WINZ) when it is not appropriate to provide such information.
Medical practitioners need to give consideration to the content of the employer’s policies and the employee’s Individual or Collective Employment Agreements around the collection of medical certificates. Employees may have signed the rights for the employer to seek this information from an appropriate registered medical practitioner. The medical practitioner should not hide behind the Privacy Act if the employee has clearly given the employer authority to collect such information. The onus is on the employee to provide the approval to the medical practitioner, rather than the medical practitioner informing the employee of their rights.
HRINZ members would like to see more accountability from medical practitioners to the Medical Council Guidelines and practices.
HRINZ Members would like medical practitioners to be clearer on the letters written when ‘stress’ is the diagnosis rather than having HR practitioners needing to educate medical practitioners about what is required. In particular, a clear objective diagnosis about what aspects of the employee’s work duties may be contributing to or impacted by the employee’s condition, with clear separation of what aspects of the employee’s personal (non-work) life may also impact. Employers only need to know the work impacts – however there is frustration that some medical practitioners are too quick to lay all issues at the fault of the employee’s work duties without even understanding what those duties actually comprise.
HRINZ members would like to see more guidelines around the likely return to work rather than providing vague statements e.g. “the employee is unfit for work for two weeks’. What does that mean? Is the employee capable of returning to full duties at the end of the two weeks or gradual easing into work, what is the employee capable of doing?
HRINZ acknowledges that Section 68 of the Holidays Act 2003 adds confusion around the issuing of medical certificates and the statements required. This will need to be addressed at some stage.
2. Do you agree with the changes proposed? If not, why not?
HRINZ agrees with the statements proposed.
3. Are any additional changes required? If so, what are they
Consideration that medical certificates provided are fit for purpose and meet the needs of the agencies requiring the information, e.g. employers’ needs are most likely to be different than those of agencies such as WINZ or ACC.
4. Is the footnote providing employers and other receiving agencies with advice on how to seek more information from a doctor useful? Is there any other advice that should be included?
HRINZ agrees to the proposed footnote. However, if the medical certificates issued contained sufficient information in the first instance for the agencies to make an informed decision about the employee, there should not be the need to seek additional information.
5. Do you agree with the change proposed to paragraph 9? If not, why not?
HRINZ agrees with the change proposed. All information should be fit for purpose and contain relevant information only. HRINZ members are only interested in the information around the employee’s ability to return to work and in what capacity. It should contain information or recommendations to the employer on any additional specific equipment, facilities or other needs to support and accommodate the return to work of the employee.
6. Do you agree with the changes proposed? If not, why not?
HRINZ agrees that any additional costs be clearly visible to the agency paying for the service.
7. Do you agree with the changes proposed? If not, why not?
HRINZ agrees with the proposed changes.
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